What question did this study set out to answer?

The aim is to determine the predictive value of serum chloride levels for in-hospital mortality in patients with profound hyponatremia on maintenance hemodialysis.

March 28, 2026Open Access

Wcn26-4806 Predictive Model for in-Hospital Mortality in Patients With Profound Hyponatremia Using Baseline Data

Resultado clave

Lower serum chloride independently predicted higher all-cause mortality in maintenance hemodialysis patients, with the lowest tertile showing a hazard ratio of 1.69 compared to the highest.

Puntos clave

The aim is to determine the predictive value of serum chloride levels for in-hospital mortality in patients with profound hyponatremia on maintenance hemodialysis.
Analyzed data from patients with profound hyponatremia on maintenance hemodialysis
Divided cohort into tertiles based on serum chloride levels
Employed Kaplan-Meier and Cox regression analyses to assess associations
Identified lower serum chloride as a significant predictor of all-cause mortality
Cox regression yielded hazard ratios of 1.69 for the lowest chloride tertile and 1.37 for the middle tertile compared to the highest
The association remained significant after adjusting for multiple confounders

PICO estructurado

Población

Patients with profound hyponatremia (serum sodium ≤120 mEq/L) admitted to a tertiary medical center in Japan between 2014 and 2024. Median age 76 years.

Intervención

Machine learning predictive models (including logistic regression, support vector machine, random forest, XGBoost, and LightGBM) using 20 clinical features selected via LASSO, recursive feature elimination (RFE), and SelectKBest.

Resultado

In-hospital mortalityhard clinical

In patients with profound hyponatremia, in-hospital mortality is strongly determined by underlying comorbidities and nutritional status rather than the severity of hyponatremia itself.

Resultado numérico

Tasa de eventos absoluta: 0% vs 0%

Resumen

Results:The median (IQR) age and dialysis duration were 68 (60, 75) years and 64 (29, 133) months, respectively.The cohort was divided into tertiles based on CL (T1, 86-100 mEq/L, N = 544; T2, 101-103 mEq/L, N = 508; T3, 104-116 mEq/L, N = 601).We identified 467 cases with ACM.Kaplan-Meier analysis showed an inverse association between CL and ACM.The inverse association was significant even in Cox regression analysis adjusted for 24 potential confounders with the hazard ratio 95%CI of1.69 1.34, 2.13 for T1 and 1.37 1.08, 1.74 for T2 as compared to T3.The inverse association was consistent across various subgroups and remained significant after additional adjustment for serum Na, K, use of RASi, and use of loop diuretics.Conclusion: A lower serum CL is a novel and independent predictor of ACM in patients on MHD.Further studies are needed to elucidate the mechanisms behind the observed association and to clarify the clinical impact of this observation.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.

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Cite This Study

Nagase et al. (Wed,) reported a other. Lower serum chloride independently predicted higher all-cause mortality in maintenance hemodialysis patients, with the lowest tertile showing a hazard ratio of 1.69 compared to the highest.

synapsesocial.com/papers/69c76fff8bbfbc51511e064b https://doi.org/https://doi.org/10.1016/j.ekir.2026.103828

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